Division of Neurosurgery, Department of Neurosciences, Policlinico "G. Rodolico", University Hospital, Catania, Italy.
Multidisciplinary Research Center on Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy.
Radiol Oncol. 2020 Dec 3;55(1):26-34. doi: 10.2478/raon-2020-0071.
One of the greatest neuro-oncological concern remains the lack of knowledge about the etiopathogenesis and physiopathology of gliomas. Several studies reported a strict correlation between radiological features and biological behaviour of gliomas; in this way the velocity of diametric expansion (VDE) correlate with lower grade glioma aggressiveness. However, there are no the same strong evidences for high grade gliomas (HGG) because of the lack of several preoperative MRI.
We describe a series of 4 patients affected by HGG followed from 2014 to January 2019. Two patients are male and two female; two had a pathological diagnosis of glioblastoma (GBM), one of anaplastic astrocytoma (AA) and one had a neuroradiological diagnosis of GBM. The VDE and the acceleration time (AT) was calculated for fluid attenuated inversion recovery (FLAIR) volume and for the enhancing nodule (EN). Every patients underwent sequential MRI study along a mean period of 413 days.
Mean VDE evaluated on FLAIR volume was 39.91 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 282.7%. Median appearance time of EN after first MRI scan was 432 days. Mean VDE was 45.02 mm/year. Mean percentage ratio between peak values and mean value of acceleration was 257.52%.
To our knowledge, this is the first report on VDE and acceleration growth in HGG confirming their strong aggressiveness. In a case in which we need to repeat an MRI, time between consecutive scans should be reduced to a maximum of 15-20 days and surgery should be executed as soon as possible.
神经肿瘤学最大的关注点之一仍然是缺乏对胶质瘤的病因发病机制和病理生理学的了解。几项研究报告了影像学特征与胶质瘤生物学行为之间的严格相关性；在这种情况下，直径扩张速度（VDE）与低级胶质瘤的侵袭性相关。然而，由于缺乏几项术前 MRI，高级别胶质瘤（HGG）并没有同样强有力的证据。
我们描述了从 2014 年到 2019 年 1 月随访的 4 例 HGG 患者。2 例为男性，2 例为女性；2 例病理诊断为胶质母细胞瘤（GBM），1 例为间变性星形细胞瘤（AA），1 例为神经放射学诊断为 GBM。VDE 和加速时间（AT）是根据液体衰减反转恢复（FLAIR）体积和增强结节（EN）计算的。每位患者均接受了平均 413 天的连续 MRI 研究。
FLAIR 体积上评估的平均 VDE 为 39.91mm/年。加速峰值与平均比值的中位数为 282.7%。首次 MRI 扫描后 EN 的中位出现时间为 432 天。平均 VDE 为 45.02mm/年。加速峰值与平均比值的中位数为 257.52%。
据我们所知，这是首次报道 HGG 中的 VDE 和加速生长，证实了它们的强烈侵袭性。在需要重复 MRI 的情况下，两次连续扫描之间的时间应缩短至最多 15-20 天，并应尽快进行手术。
